| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
60,193 |
48,656 |
$6.09M |
| D0120 |
Periodic oral evaluation - established patient |
8,656 |
8,435 |
$250K |
| D1110 |
Prophylaxis - adult |
2,634 |
2,578 |
$163K |
| D1208 |
Topical application of fluoride, excluding varnish |
6,516 |
6,476 |
$147K |
| D0274 |
Bitewings - four radiographic images |
4,108 |
3,987 |
$142K |
| D1120 |
Prophylaxis - child |
2,867 |
2,829 |
$126K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
585 |
511 |
$74K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
660 |
562 |
$59K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
782 |
765 |
$44K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,064 |
871 |
$27K |
| D0220 |
Intraoral - periapical first radiographic image |
1,341 |
1,305 |
$17K |
| D1206 |
Topical application of fluoride varnish |
715 |
614 |
$15K |
| D1351 |
Sealant - per tooth |
229 |
63 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,257 |
9,629 |
$7K |
| D0330 |
Panoramic radiographic image |
173 |
168 |
$7K |
| D0272 |
Bitewings - two radiographic images |
123 |
122 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
145 |
142 |
$2K |
| D4355 |
|
15 |
14 |
$830.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,369 |
1,333 |
$699.65 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
28 |
12 |
$643.72 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,044 |
2,724 |
$330.24 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,576 |
1,420 |
$313.62 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
32 |
31 |
$211.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,175 |
8,032 |
$67.58 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,604 |
3,541 |
$58.50 |
| 96127 |
|
2,798 |
2,695 |
$15.86 |
| D0999 |
Unspecified diagnostic procedure, by report |
14,541 |
13,779 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
2,536 |
1,000 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,819 |
2,268 |
$0.00 |
| 90723 |
|
170 |
170 |
$0.00 |
| 92551 |
|
2,130 |
2,089 |
$0.00 |
| 90474 |
|
368 |
367 |
$0.00 |
| 90656 |
|
229 |
224 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
770 |
766 |
$0.00 |
| 90686 |
|
3,335 |
3,234 |
$0.00 |
| 91305 |
|
191 |
181 |
$0.00 |
| 90680 |
|
583 |
581 |
$0.00 |
| 91306 |
|
42 |
42 |
$0.00 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
673 |
390 |
$0.00 |
| 96161 |
|
211 |
208 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17 |
17 |
$0.00 |
| 90647 |
|
95 |
95 |
$0.00 |
| 91307 |
|
602 |
583 |
$0.00 |
| 99381 |
|
131 |
125 |
$0.00 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
360 |
229 |
$0.00 |
| 0072A |
|
283 |
283 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
159 |
142 |
$0.00 |
| 90697 |
|
399 |
397 |
$0.00 |
| 91301 |
|
78 |
76 |
$0.00 |
| 97802 |
|
88 |
87 |
$0.00 |
| 90674 |
|
20 |
20 |
$0.00 |
| 0064A |
|
58 |
58 |
$0.00 |
| 90677 |
|
266 |
263 |
$0.00 |
| 0001A |
|
113 |
113 |
$0.00 |
| 0081A |
|
15 |
15 |
$0.00 |
| 90651 |
|
45 |
45 |
$0.00 |
| 81000 |
|
34 |
33 |
$0.00 |
| 0052A |
|
12 |
12 |
$0.00 |
| 0012A |
|
17 |
17 |
$0.00 |
| 90688 |
|
57 |
56 |
$0.00 |
| 0011A |
|
20 |
20 |
$0.00 |
| 90696 |
|
21 |
21 |
$0.00 |
| 90716 |
|
13 |
13 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
15 |
14 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
14 |
14 |
$0.00 |
| 0082A |
|
15 |
15 |
$0.00 |
| 87428 |
|
13 |
13 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
17 |
16 |
$0.00 |
| 81025 |
|
249 |
235 |
$0.00 |
| 0071A |
|
215 |
214 |
$0.00 |
| 99188 |
|
187 |
187 |
$0.00 |
| 97803 |
|
650 |
583 |
$0.00 |
| 91300 |
|
635 |
613 |
$0.00 |
| D2999 |
|
6,058 |
5,320 |
$0.00 |
| 99173 |
|
1,747 |
1,710 |
$0.00 |
| 90670 |
|
534 |
522 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
311 |
295 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
981 |
932 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
429 |
387 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
652 |
597 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,441 |
2,194 |
$0.00 |
| 99177 |
|
486 |
466 |
$0.00 |
| 0002A |
|
312 |
312 |
$0.00 |
| 90461 |
|
212 |
187 |
$0.00 |
| 90633 |
|
196 |
196 |
$0.00 |
| 91308 |
|
68 |
66 |
$0.00 |
| 90671 |
|
222 |
220 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
26 |
26 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,586 |
1,071 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
190 |
177 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
26 |
25 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
619 |
392 |
$0.00 |
| 90672 |
|
16 |
16 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
51 |
27 |
$0.00 |
| D0191 |
|
158 |
143 |
$0.00 |
| 90715 |
|
30 |
29 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
52 |
52 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$0.00 |
| 0004A |
|
26 |
26 |
$0.00 |
| 0054A |
|
44 |
43 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
37 |
37 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
244 |
237 |
$0.00 |
| 90710 |
|
36 |
33 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 90473 |
|
16 |
16 |
$0.00 |